The influence of the menstrual cycle, normal pregnancy and pre-eclampsia on platelet activation

2010 ◽  
Vol 103 (02) ◽  
pp. 372-378 ◽  
Author(s):  
Amy Robb ◽  
Jehangir Din ◽  
Nicholas Mills ◽  
Imogen Smith ◽  
Anders Blomberg ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Pregnant Women ◽  
Platelet Activation ◽  
Post Partum ◽  
Normal Pregnancy ◽  
Cd40 Ligand ◽  
Platelet Surface ◽  
Soluble P ◽  
In Pregnancy

SummaryPlatelet activation has a key role in mediating thrombotic and inflammatory events. This study aimed to determine the influence of the menstrual cycle, pregnancy and preeclampsia on in vivo platelet activation. Twelve healthy nulliparous, non-smoking women with regular menses were studied over a single menstrual cycle. Twenty-one healthy primigravida pregnant women were studied longitudinally at 16, 24, 32 and 37 weeks gestation and seven weeks post-partum. Sixteen primigravida women with preeclampsia were studied at time of diagnosis and at seven weeks post-partum. Platelet-monocyte aggregates and platelet-surface P-selectin expression were assessed by flow-cytometry. Soluble P-selectin and CD40 ligand (CD40L) were measured by ELISA. Markers of platelet activation did not vary over the menstrual cycle. Platelet-monocyte aggregates were greater in the third trimester of pregnancy compared to non-pregnant women (p=0.003). Platelet surface and plasma soluble P-selectin concentrations increased with gestation (p<0.0001) and were raised by 24 weeks of pregnancy compared to non-pregnant women (p≤0.02 for both) and together with platelet monocyte aggregates, decreased post-partum (p≤0.02). Soluble CD40L concentrations fell in pregnancy, reaching a nadir at mid-gestation (p=0.002). There were no differences in markers of platelet activation between normal and pre-eclamptic pregnancies. In conclusion, platelet activation is increased in pregnancy and increases with gestation but is unaffected by preeclampsia. This suggests that systemic platelet activation is a feature of pregnancy but this is not affected by established preeclampsia.

GAMBARAN PENGETAHUAN, UMUR,DUKUNGAN SUAMI, DAN EKONOMI, PADA IBU HAMIL TENTANG KEPATUHAN PEMERIKSAAN KLINIK PRATAMA SANTA ELISABETH MEDAN

2020 ◽  
Vol 5 (02) ◽  
pp. 80-88
Author(s):  
Lilis Sumardiani
Keyword(s):  
Data Analysis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Frequency Distribution ◽  
Post Partum ◽  
Number Of Children ◽  
Mothers And Children ◽  
Knowledge Age ◽  
Husband Support ◽  
In Pregnancy

Introduction :antenatal care is an examination of pregnant women both physically and mentally as well as saving mothers and children in pregnancy, childbirth and the puerperium, so that they post partum healthy and normal not only physically but also mentallyMethod : The study was conducted by distributing questionnaires to pregnant women with emesis gravidarum. Data analysis using univariants for frequency distribution. Result : The results showed an overview of knowledge of pregnant women with good knowledge of 13 people (65%), sufficient knowledge of 5 people (25%) and lack of knowledge of 1 person (5%) while lacking knowledge of pregnant women who did not comply did 1 pregnancy check up (5) %). overall obedient pregnant women undergo pregnancy examinations aged <20 years 7 people (35%), 20-30 years there are 7 people (35%) and there are 4 people> 35 years (20%). while those aged <20 years who are not compliant pregnant women do pregnancy examinations 2 people (10%). pregnant women about compliance with antenatal care namely, support from the husband is very good there are 12 people (60%), good 4 people (20%) and enough 4 people (40%). 20%), the middle economy there are 13 people (65%), and the low economy 4 people (20%), while the economy is lacking in pregnant women who do not comply with one pregnancy checkup (5%). parity, shows that the total number of pregnant women regarding compliance with antenatal care is, that has children who live 1 times 4 people (20%), the number of children who live 2-5 times 11 people (55%), and the number of children who live> 5 times 5 people (25%) while parity, in pregnant women who do not comply with pregnancy examination 1 person (5%) Duscussion:From this study it can be concluded that knowledge, age, husband support, economy and parity in pregnant women regarding compliance with antenatal care in the Klinik Pratama Santa Elisabeth Medan is said to be a minority who are disobedient and more who are obedient do ANC visits

Partially desulfated heparin modulates the interaction between anti-protamine/heparin antibodies and platelets

2016 ◽  
Vol 115 (02) ◽  
pp. 324-332 ◽  
Author(s):  
Rabie Jouni ◽  
Heike Zöllner ◽  
Ahmad Khadour ◽  
Jan Wesche ◽  
Anne Grotevendt ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Platelet Factor ◽  
Standard Drug ◽  
Platelet Surface ◽  
Minimal Impact ◽  
Platelet Survival ◽  
Heparin Complexes ◽  
The Impact

SummaryProtamine (PRT) is the standard drug to neutralise heparin. PRT/heparin complexes induce an immune response similar to that observed in heparin-induced thrombocytopenia (HIT). Partially desulfated heparin (ODSH) was shown to interfere with anti-platelet factor 4/heparin antibodies (Abs), which are responsible for HIT. In this study, we analyse the impact of ODSH on the interaction between anti-PRT/heparin Abs and platelets. The ability of ODSH to prevent anti-PRT/heparin Ab-induced platelet destruction in vivo was investigated using the NOD/ SCID mouse model. ODSH improved platelet survival in the presence of PRT, heparin and anti-PRT/heparin Abs (median platelet survival after 300 minutes (min) with 20 μg/ml ODSH: 75 %, range 70–81 % vs without ODSH: 49%, range 44–59%, p=0.006). Furthermore, when ODSH was applied 60 min after Ab injection platelet survival was improved (median platelet survival after 300 min with ODSH: 83 %, range 77–93 % vs without ODSH: 59 %, range 29–61 %, p=0.02). In in vitro experiments ODSH inhibited platelet activation at concentrations > 16 μg/mL (p< 0.001), as well as PRT/heparin complex binding to platelets (mean fluorescence intensity [MFI] without ODSH: 85 ± 14 vs with ODSH: 15 ± 0.6, p=0.013). ODSH also displaced pre-bound complexes from the platelet surface (MFI without ODSH: 324 ± 43 vs with 32 μg/ml ODSH: 53 ± 9, p< 0.001). While interfering with platelet activation by anti-PRT/heparin Abs, up to a concentration of 16 μg/ml, ODSH had only minimal impact on neutralisation of heparin by PRT. In conclusion, our study shows that ODSH is able to inhibit platelet activation and destruction suggesting a potential clinical use to reduce anti-PRT/heparin Ab-mediated adverse effects.

Fibrin monomer complex in normal pregnant women: a potential thrombotic marker in pregnancy

2007 ◽  
Vol 44 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Hiroaki Onishi ◽  
Kimiko Kaniyu ◽  
Mitsutoshi Iwashita ◽  
Asashi Tanaka ◽  
Takashi Watanabe
Keyword(s):  
Pregnant Women ◽  
Late Pregnancy ◽  
Normal Pregnancy ◽  
Reference Ranges ◽  
Vein Thrombosis ◽  
Fibrin Monomer ◽  
Potential Marker ◽  
Deep Vein ◽  
Positive Results ◽  
In Pregnancy

Background: Pregnancy represents a major risk factor for deep vein thrombosis (DVT). Most coagulation/fibrinolysis markers currently utilized change during pregnancy, and therefore they cannot accurately evaluate thrombotic events in pregnancy because the rate of false positive results is high. Fibrin monomer complex (FMC) has recently become widely available for diagnosing DVT. The present study examined whether FMC is suitable for evaluating thrombotic status in pregnancy. Methods: Concentrations of FMC and other haemostatic markers were investigated in 87 pregnant women without major complications at early, mid- or late pregnancy. FMC concentrations were also measured in 127 normal non-pregnant women, and in one woman who developed DVT after delivery. Results: In normal pregnant women, FMC concentrations were unchanged during early or mid-pregnancy and slightly elevated during late pregnancy. Concentrations were within reference range in most cases, and none exceeded the cut-off value for DVT. In contrast, thrombin-antithrombin complex (TAT) and D-dimer (DD) concentrations were significantly elevated in late pregnancy, and median values exceeded reference ranges. The DVT case displayed significantly elevated FMC concentrations. Conclusions: Changes in FMC concentrations during normal pregnancy are minimal compared with other haemostatic markers. Because the rate of false positivity is lower, FMC could be a potential marker of thrombotic status in pregnancy rather than TAT and DD.

scholarly journals Hyperlipidemia in pregnancy

2011 ◽  
Vol 152 (19) ◽  
pp. 753-757 ◽  
Author(s):  
Tatjána Ábel ◽  
Anna Blázovics ◽  
Márta Kemény ◽  
Gabriella Lengyel
Keyword(s):  
Cardiovascular Disease ◽  
Acute Pancreatitis ◽  
Cohort Studies ◽  
Pregnant Women ◽  
Breast Feeding ◽  
Normal Pregnancy ◽  
Large Cohort ◽  
Physiological Changes ◽  
Teratogenic Effects ◽  
In Pregnancy

Physiological changes in lipoprotein levels occur in normal pregnancy. Women with hyperlipoproteinemia are advised to discontinue statins, fibrates already when they consider pregnancy up to and including breast-feeding the newborn, because of the fear for teratogenic effects. Hypertriglyceridemia in pregnancy can rarely lead to acute pancreatitis. Management of acute pancreatitis in pregnant women is similar to that used in non-pregnant patients. Further large cohort studies are needed to estimate the consequence of supraphysiologic hyperlipoproteinemia or extreme hyperlipoproteinemia in pregnancy on the risk for cardiovascular disease later in life. Orv. Hetil., 2011, 152, 753–757.

Endocrine disorders in pregnancy

2018 ◽  
pp. 283-296
Author(s):  
Helen E. Turner ◽  
Richard Eastell ◽  
Ashley Grossman
Keyword(s):  
Thyroid Hormone ◽  
Hyperemesis Gravidarum ◽  
Post Partum ◽  
Management Strategies ◽  
Normal Pregnancy ◽  
Endocrine Disorders ◽  
Pituitary Diseases ◽  
Pregnant State ◽  
Pituitary Adrenal Axis ◽  
In Pregnancy

This chapter discusses thyroid, adrenal, and pituitary diseases that occur during pregnancy. A series of changes in thyroid hormone economy take place in normal pregnancy. As a result of these changes, thyroid hormone levels in pregnancy differ from those in the non-pregnant state. This chapter includes a description of normal thyroid physiology and thyroid pathophysiology, including hyperemesis gravidarum, post-partum thyroiditis, hypothyroidism, and hyperthyroidism. Changes in the hypothalamo-pituitary–adrenal axis during normal and abnormal pregnancies are also described, with syndromes such as Cushing’s syndrome and Addison’s disease listed. Finally, pituitary adenomas in pregnancy, and their respective features and management strategies, are listed, including acromegaly, hypopituitarism, TSH-secreting adenomas, and prolactinoma.

scholarly journals Functional Status of Maternal Thyroid Gland in Eclampsia

2019 ◽  
Vol 31 (1) ◽  
pp. 9-14
Author(s):  
M Hafizur Rahman ◽  
Mahbub Ara Chowdhury ◽  
Shahin Mahmuda
Keyword(s):  
Pregnant Women ◽  
Normal Pregnancy ◽  
Hormonal Changes ◽  
Free Triiodothyronine ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Maternal Thyroid ◽  
Complicated Pregnancy ◽  
In Pregnancy

Marked changes in maternal thyroid activity occur in pregnancy. During pregnancy bodily hormonal changes and metabolic demands result in complex alteration in the bio-chemical parameters of thyroid activities. Besides these, thyroid enlargement, increased thyroid capability for iodine uptake and increase in basal metabolic rate are evidential though these findings are not usually associated with symptoms of hyperthyroidism in pregnancy. Serum concentration of thyroid hormone thyroxine and triiodothyronine in complicated pregnancy like eclamptic toxemia is another field of controversy. To evaluate the changes in thyroid function in normal pregnancy and eclamptic toxemia, a study was undertaken in Rajshahi Medical College Hospital. We collected serum specimens from non pregnant but married women, normal 3rd trimester pregnant women and patients with eclampsia at 3rd trimester of pregnancy and measured serum concentrations of total and free thyroxine (TT4 & FT4) and total and free triiodothyronine (TT3 & FT3 ) by using RIA. Among the study subjects, 10 women were married but non pregnant, 12 women were in their 3rd trimester of normal pregnancy and 32 patients of eclamptic toxemia with 3rd trimester of pregnancy. In normal pregnancy, FT4 and FT3 levels remained normal while TT4 and TT3 levels were elevated. In patients with toxemia of pregnancy, the mean serum TT3 concentration was significantly lower than that of normal pregnancy and the serum FT3 concentrations were below the normal pregnancy range. The mean serum TT4 and FT4 concentrations in patients with eclampsia were however, significantly higher than those in normal pregnant women. TAJ 2018; 31(1): 9-14

scholarly journals The diets of pregnant and post-pregnant women in different social groups in London and Edinburgh: energy, protein, fat and fibre

1987 ◽  
Vol 58 (3) ◽  
pp. 369-381 ◽  
Author(s):  
Claire Schofield ◽  
Erica Wheeler ◽  
Judy Stewart
Keyword(s):  
Pregnant Women ◽  
Post Partum ◽  
Social Groups ◽  
Social Classes ◽  
Dietary Energy ◽  
Lactating Women ◽  
Dietary Records ◽  
In Pregnancy

1. Dietary records were obtained twice in pregnancy and once post-partum from 265 women from all social classes in London and Edinburgh.2. The London women always had higher mean energy, protein, fat and fibre intakes. Significant between-region differences emerged.3. Some between-social classes differences occurred, but were not consistently significant.4. All mean energy and fibre intakes were lower, and protein and fat intakes were higher, than current recommendations.5. Of lactating women 15% claimed to be dieting.6. The percentage dietary energy derived from fat varied from 36 (in a dieting group) to 42.

Junctional Adhesion Molecule a Helps Maintain Integrin αIIbβ3 in Resting State

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 111-111 ◽  
Author(s):  
Meghna Ulhas Naik ◽  
Timothy J. Stalker ◽  
Lawrence F. Brass ◽  
Ulhas Pandurang Naik
Keyword(s):  
Platelet Aggregation ◽  
Platelet Activation ◽  
Adhesion Molecule ◽  
Resting State ◽  
Human Platelets ◽  
Artery Occlusion ◽  
In Vivo Model ◽  
Platelet Surface ◽  
Integrin Αiibβ3

Abstract Under physiological conditions, fibrinogen receptor integrin αIIbβ3 on the circulating platelets is in a low-affinity, or resting state, unable to bind soluble ligands. During platelet activation by agonists, a cascade of signaling events induces a conformational change in the extracellular domain of αIIbβ3, thereby converting it into a high-affinity state capable of binding ligands through a process known as “inside-out signaling”. What maintains this integrin in a low-affinity state is not well understood. We have previously identified JAM-A, junctional adhesion molecule A, on the platelet surface. We have shown that an antibody blockade of JAM-A dose-dependently activates platelets. To understand the molecular mechanism through which JAM-A regulates platelet aggregation, we used Jam-A null mice. Interestingly, the mouse bleeding times were significantly shortened in Jam-A null mice compared to wildtype littermates. Furthermore, the majority of these mice showed a rebleeding phenotype. This phenotype was further confirmed by FeCl3-induced carotid artery occlusion, a well-accepted in vivo model for thrombosis. Platelets derived from Jam-A-null mice were used to evaluate the role of JAM-A in agonist-induced platelet aggregation. We found that Jam-A null platelets showed enhanced aggregation in response to physiological agonists such as PAR4 peptide, collagen, and ADP as compared to platelets from wildtype littermates. JAM-A was found to associate with αIIbβ3 in unactivated human platelets, but this association was disrupted by both agonist-induced platelet aggregation and during outside-in signaling initiated upon platelet spreading on immobilized Fg. We also found that in resting platelets, JAM-A is phosphorylated on a conserved tyrosine 280 in its cytoplasmic domain, which was dephosphorylated upon platelet activation. Furthermore, JAM-A is rapidly and transiently phosphorylated on serine 284 residue during platelet activation by agonists. Interestingly, JAM-A also formed a complex with Csk, a tyrosine kinase known to be inhibitory to Src activation, in resting platelets. This complex was dissociated upon activation of platelets by agonists. These results suggest that tyrosine-phosphorylated JAM-A recruits Csk to αIIbβ3 in resting platelets, thus maintaining a low-affinity state of integrin αIIbβ3. Agonist–induced activation of platelets results in rapid dephosphorylation of JAM-A on Y280 and phosphorylation on S284 residues. This causes dissociation of JAM-A from integrin αIIbβ3 facilitating platelet aggregation.

scholarly journals In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation

Blood ◽  
2012 ◽  
Vol 119 (17) ◽  
pp. 4066-4072 ◽  
Author(s):  
Bethan Psaila ◽  
James B. Bussel ◽  
Matthew D. Linden ◽  
Bracken Babula ◽  
Youfu Li ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Platelet Function ◽  
Whole Blood ◽  
Immune Thrombocytopenia ◽  
Ex Vivo ◽  
Platelet Reactivity ◽  
Adenosine Diphosphate ◽  
High Dose ◽  
Platelet Surface

Abstract The effects of eltrombopag, a thrombopoietin-receptor agonist, on platelet function in immune thrombocytopenia (ITP) are not fully characterized. This study used whole blood flow cytometry to examine platelet function in 20 patients receiving eltrombopag treatment at days 0, 7, and 28. Platelet surface expression of activated GPIIb/IIIa, P-selectin, and GPIb was measured with and without low and high adenosine diphosphate (ADP) and thrombin receptor activating peptide (TRAP) concentrations. Before eltrombopag treatment with no ex vivo agonist, platelet activation was higher in ITP patients than controls. Platelet GPIb and activated GPIIb/IIIa expression without added agonist was unchanged following eltrombopag treatment, whereas a slight increase in P-selectin was observed. Expression of P-selectin and activated GPIIb/IIIa in response to high-dose ADP was lower during eltrombopag treatment than at baseline. Eltrombopag led to a slight increase in platelet reactivity to TRAP only in responders to eltrombopag but not to levels above those in controls; whole blood experiments demonstrated that this increase was probably because of higher platelet counts rather than higher platelet reactivity. In conclusion, although thrombocytopenic ITP patients have higher baseline platelet activation than controls, eltrombopag did not cause platelet activation or hyper-reactivity, irrespective of whether the platelet count increased.

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